ABSTRACT
OBJECTIVE@#To evaluate the effect of bilateral atlantoaxial lamina hook and atlantoaxial joint space screw combined with autologous iliac bone graft on atlantoaxial dislocation caused by acute type I transverse ligament injury in school-age children.@*METHODS@#From February 2006 to February 2019, 8 school-age children with atlantoaxial dislocation caused by acute type I transverse ligament injury were systematically reviewed, including 6 males and 2 females; aged 9 to 12 years old; 8 acute injuries included 4 high-level falls, 2 car accidents and 2 sports injuries; the atlantoaxial interval(ADI) was 5 to 8 mm. Eight cases presented with pain, stiffness, numbness and cervical spine dysfunction in different degrees. Two of them were accompanied by nerve compression and ASIA grade D. The preoperative C₁,₂ angle averaged 20.7° to 23.4°. All patients received cranial traction and surgical treatment after complete reduction or atlantoaxial reduction. The changes of Japanese Orthopaedic Association(JOA) score, space available for the cord(SAC), neck disability index(NDI), ADI, ASIA classification(ASIA) injury classification(1992) and C₁,₂ angle before and after treatment were observed.@*RESULTS@#The average follow-up time was 8 to 156 months. Clinical and radiological follow-up showed that the atlantoaxial joint was completely relieved, the reduction was satisfactory and the arthrodesis was stable. Nerve and vascular injuries associated with this technique were not observed. JOA score, SAC, NDI, C₁,₂ angle of the last follow-up of the children were significantly improved. Two children of ASIA grade D recovered to grade E.@*CONCLUSIONS@#Bilateral atlantoaxial lamina hook and atlantoaxial joint space screw combined with autologous iliac bone graft is simple, less bleeding, strong stability and high fusion rate. It is an ideal surgical procedure for acute type I transverse ligament injury with atlantoaxial dislocation in school-age children.
Subject(s)
Child , Female , Humans , Male , Atlanto-Axial Joint , General Surgery , Bone Screws , Joint Dislocations , Ligaments , Spinal Fusion , Treatment OutcomeABSTRACT
Background: The suprascapular notch is a semicircular notch located at the superior border of the scapula, just medial to the base of the coracoid process which constitutes the main site of compression of the suprascapular nerve. The aim of present study is to study morphological variations of the suprascapular notch in the North Indian population, classify the suprascapular notch into various types and to correlate the type of notch to the incidence of suprascapular nerve entrapment syndrome. Materials and Methods: Material for the present study comprised of 100 adult scapulae (Right : Left :: 50:50) of unknown age and sex, obtained from Department of Anatomy, Govt. Medical College, Amritsar, Punjab, India. Results: Suprascapular notch was present in 95% bones, was transversely oval in 66%, vertical diameter = 5.9mm (3.29-16.80mm), transverse diameter = 5.96mm(2.93-13.70mm), distance from the base of suprascapular notch to the superior rim of glenoid = 29.98mm (21.7-39.25mm). It was classified as per Natsis et al classification into type I (20%), type II (39%), type III (34%), type IV (5%) and type V (2%). Our results were compared with the studies of other authors. Conclusions: The knowledge of classification and the anatomical variations of suprascapular notch helps the clinician to define easily and quickly the type of notch and be able to correlate suprascapular nerve entrapment with a specific type of notch.
ABSTRACT
The objective was to study the morphology and morphometry of transverse ligament of the knee joint in south Indian population. The present study included 53 formalin fixed foetuses which were obtained from the department of Anatomy. There were 106 knee joints which were available for the present study. A vernier caliper of 0.02 mm accuracy was used to measure the length of the transverse ligament. Among our specimens, transverse ligament of the knee was observed in 87.7% of the cases. It was observed bilaterally in 81.1% of cases. The double transverse ligaments were not observed in any of our specimens. The mean length of the transverse ligament measured 3.7 ± 1.5 mm. The statistically significant difference was not observed between the right and left sided transverse ligaments or gender with regard to its length (Student's t test; p > 0.05). The morphological and morphometric data related to the transverse ligament of the knee in human foetuses have not been reported. The present study provides additional information on the morphology and morphometry of the transverse ligament in human foetuses. We believe that the data of the present study will provide support to the foetal anatomy, concerning the surgical procedures and arthroscopy of the knee joint. The findings are enlightening not only for Orthopedic Surgeons, but also for the Morphologists and Embryologists.